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General NPI Number Information
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NPI Number | 1881830297
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Entity Type | Organization
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Legal Business Name | HAUG CHIROPRACTIC CLINIC, P.A.
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 113 S A ST
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City | GRANGEVILLE
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State | ID
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Zip | 83530-1428
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Country | US
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Telephone | 208-983-2458
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Fax | 208-983-1554
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Provider Business Mailing Address
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Address Line | 113 S A ST PO BOX 8
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City | GRANGEVILLE
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State | ID
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Zip | 83530-1428
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Country | US
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Telephone | 208-983-2458
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Fax | 208-983-1554
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES MICHAEL HAUG
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Credential | D.C.
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Telephone | 208-983-2458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | C552
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License Number State | ID
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